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To fight COVID-19, a young epidemiologist bridges the gulf between science and U.S. politics

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“We must not become numb. Those numbers represent … people who were loved,” says Caitlin Rivers of Johns Hopkins Center for Health Security.

 

KATTY HUERTAS

Science’s COVID-19 reporting is supported by the Pulitzer Center and the Heising-Simons Foundation.

In May, epidemiologist Caitlin Rivers made a rare outing amid coronavirus stay-at-home orders. She had been called for the first time in her career to testify before Congress—and she was intimidated. “You’re looking at the dais and seeing all these eminent people. It’s a really powerful experience,” she says.

Then, questions about the U.S. response to COVID-19 started to fly, and Rivers was in her element. Five years out of graduate school, she is already well-versed in talking to policymakers about the science of pandemics. She has developed models to predict the spread of Middle East respiratory syndrome and Ebola, briefed the Department of Defense (DOD) on outbreak response, and tracked respiratory disease among Army service members. She’s now at the Johns Hopkins Center for Health Security, a think tank that advises U.S. and international leaders on epidemics and disasters.

In formal reports, private conversations with congressional staffers and local officials, and a growing presence on Twitter and in the popular press, Rivers has emerged as a clear-eyed, tactful narrator of the unfolding pandemic. “One of my goals,” she says, “is keeping the energy—the intention—around the bigger question, ‘Are we headed in the right direction?’”

Rivers got interested in epidemiology as an undergraduate at the University of New Hampshire, inspired in part by Tracy Kidder’s book Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, a Man Who Would Cure the World, which describes the medical anthropologist’s efforts to eradicate disease in developing countries. Rivers admired “the respect that he brought to the populations that he was working with,” she says, “and just the vision—he was not about to let anything stop him.”

Rivers majored in anthropology, and she brings an “anthropologist’s understanding of how what seem to be totally different cultures can communicate with each other—the policy world and the modeling epidemiologists,” says Stephen Eubank, an epidemiological modeler at the University of Virginia (UVA) who mentored Rivers during her graduate training in epidemiology and infectious disease at the Virginia Polytechnic Institute and State University (Virginia Tech).

Her Ph.D. coincided with the outbreak of Ebola in West Africa, and in the lab of Virginia Tech epidemiologist Bryan Lewis, she helped prepare weekly updates for experts at DOD. “Caitlin would often be emailing me at like three in the morning: ‘I updated this to get this little thing in! You can put this on slide 12!’” Lewis, now also at UVA, recalls. The demands of an epidemic are “well-suited to my personality,” Rivers says. “I don’t mind working hard, and I like having a purpose.”

As she sat before an appropriations subcommittee in the House of Representatives in May, the country had made progress. Stay-at-home orders were starting to bring down new COVID-19 cases. But the nation was on the verge of widespread reopening that would put hard-won gains at risk. “We are in a critical moment of this fight,” she told the representatives, warning that a clear national plan for testing, contact tracing, and strengthening health care systems was essential to prevent tens of thousands more deaths.

As early as March, Rivers, former Food and Drug Administration Commissioner Scott Gottlieb, and colleagues at the American Enterprise Institute had laid out criteria for safely reopening businesses, including waiting for a sustained reduction in cases. In her May congressional testimony, she urged the federal government to develop a national plan to eliminate test shortages and anticipate bottlenecks in the supply of reagents and materials.

Things might have gone differently if more people in positions of power had taken Rivers’s advice. Four months later, the United States still logs tens of thousands of new cases per day and accounts for about one-fifth of the COVID-19 deaths documented worldwide.

“Things did not unfold as I would have liked them to, certainly,” Rivers says of the U.S. reopening. “Politics can get so frustrating because it feels—not necessarily as an adviser, but as a citizen—like, ‘Why can’t you see it the way that I see it?’” But, she adds, she’s sympathetic to the pressures that local decision-makers felt to restore their economies.

Laying blame and stirring controversy isn’t productive for someone eager to influence policy, Eubank says, citing National Institute of Allergy and Infectious Diseases Director Anthony Fauci’s aversion to publicly discussing his relationship with the Trump administration. Of course, Eubank adds, Fauci has decades of experience threading this needle. But Rivers understands it too, and is holding her own just a few years out of grad school.

“As a junior faculty, we don’t have anyone helping. We don’t have staff,” says Natalie Dean, a biostatistician at the University of Florida who has co-authored editorials with Rivers on how to interpret antibody studies and the need for more detailed, transparent epidemiological data. “I think we’re both adjusting to just having so many more people ask things of us.”

It’s not just politicians who are turning to Rivers for clarity on the pandemic. On Twitter, which she previously used mostly to discuss new results with colleagues, she’s made an art of giving a big-picture, 280-character view to her followers, who now number more than 140,000.

“Early in an outbreak, we often find only the most severe cases,” she tweeted in February. “It seems like people are quite sick, which is scary. It’s something of an illusion.”

As some regions turned a corner in April, she predicted “growing agitation about whether staying home was necessary. Make no mistake, it is and was.”

“We must not become numb,” she urged in July as the United States passed 150,000 deaths. “Those numbers represent people, people who were loved.”

Readers gravitate to these level-headed summaries even when the news is bad, says Dean, who describes Rivers as her “pandemic pal.” Their friendship was born on Twitter, she says, where they connected over the struggle of caring for young children while working from home. (Rivers has 19-month-old twins and a 6-year-old.)

Rivers admits the demands of the pandemic have been “a lot to manage,” but she also sees opportunities, including the chance to revive a proposal that would better prepare the country for the next viral threat. While she was in graduate school, Rivers and colleagues proposed creating a National Infectious Disease Forecasting Center, akin to the National Weather Service, that would put a coordinated team of epidemic modeling experts inside the government.

Currently, academic experts largely volunteer their time. “There is no other capability of national strategic importance that we handle like that,” she says. “We don’t let the military self-organize. We don’t let the national hurricane center be academics in various universities who volunteer.”

In 2015, the proposal seemed to have a chance. Rivers, with colleagues including biodefense adviser Dylan George, then at the White House Office of Science and Technology Policy, discussed the idea at a White House meeting on epidemic preparedness. But it never advanced to a formal initiative or a line in the federal budget. “We hit the budget cycle at the wrong time,” says George, who is now at the national security investment firm In-Q-Tel.

COVID-19 has put new momentum behind the effort. Rivers says she has been meeting with congressional staff about it, and she is hopeful that the past efforts laid the groundwork even though they didn’t pay off in time to help with COVID-19. She wishes the initiative had been launched in 2015, she says, “but the second best time is now.”

 

Source: – Science Magazine

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Bipartisan Politics | Politics and Public Affairs – Denison University

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But the ties that bind these four individuals are stronger than most. They, and several other Big Red alumni, are connected through Forbes Tate Partners, a bipartisan, full-service government and public affairs advocacy firm, founded by Forbes and his partner Dan Tate.

In today’s divisive political landscape it might be difficult to imagine that colleagues from opposite sides of the aisle can be, well, collegial. But according to Forbes, who has worked on Democratic campaigns since Al Gore’s presidential bid, that’s the whole point.

“People forget about the moderate factions in politics — and that’s where real work can be done,” says Forbes. So it made sense to build a firm that could work well with both parties and provide positive results for everyone.

And the work has become more complicated. “Lobbying has changed,” he says. “It’s not as much who you know – though that still matters. Today, you have to run a full-fledged campaign with traditional PR, social media, news updates. You have to make sure the people back home see the reason for what you are doing, to create that support before you move forward.”

So how did all these Denisonians find their way to Forbes Tate? You can credit another Denison tie, the Hilltoppers men’s a cappella group. Forbes was a member of the popular campus group, and several years ago a student Hilltopper reached out to him, struggling to figure out what to do for the summer. Forbes’ impulsive response, “Why don’t you come here?” became the beginning of an internship program that has brought scads of students from Denison’s hill to Capitol Hill.

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US vetted stars' politics to showcase Trump virus response – CKPGToday.ca

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The names were among the spreadsheets, memos, notes and other documents from September and October released by the House Oversight and Reform Committee.

The firms’ vetting came as political appointees planned to spend more than $250 million on a confidence-building campaign surrounding the virus, which has killed more than 227,000 people in the United States and is a core issue in the presidential race between Trump and Democrat Joe Biden.

While government public health campaigns are routine, the ad blitz planned by HHS was mired from the start by involvement from department spokesman Michael Caputo, a fierce loyalist and friend of Trump with little experience in the field. In September, a spokesman for Caputo said he was taking a medical leave from HHS as he battled cancer.

Trump, a Republican, has repeatedly minimized the dangers of the coronavirus, even as the nation is in its third wave of infections, with tens of thousands of cases reported each day.

According to one memo compiled by a subcontractor to Atlas Research, one of the firms hired by HHS, Caputo suggested a series of soundbites and taglines for the campaign, including “Helping the President will Help the Country.” The notes say that Caputo wanted the campaign to be “remarkable” and to rival Rosie the Riveter, the character who symbolized women who worked in factories and shipyards during World War II against Germany.

“For us, the ‘enemy’ is the virus,” Caputo said, according to the memo.

The documents also show pushback from some of the federal employees leading the work, who removed Caputo from an email chain and thanked one of the contractors for dealing with a “challenging” environment.

The Democrat-led Oversight panel said Caputo was overstepping his bounds, interfering in work that is supposed to be done by contract officers at the department and politicizing what is supposed to be nonpartisan.

“Of course, it is completely inappropriate to frame a taxpayer-funded ad campaign around ‘helping’ President Trump in the weeks and days before the election,” said House Oversight Chairwoman Carolyn Maloney, D-N.Y., and Reps. James Clyburn of South Carolina and Raja Krishnamoorthi of Illinois, both subcommittee chairmen, in a letter to HHS Secretary Alex Azar. “This theme also ignores the reality that more than 220,000 Americans have died from coronavirus — a fact that should not be whitewashed in a legitimate public health message.”

Azar put the entire project on hold earlier this month, telling the Oversight subcommittee led by Clyburn that it was being investigated internally.

“I have ordered a strategic review of this public health education campaign that will be led by our top public health and communications experts to determine whether the campaign serves important public health purposes,” Azar told the subcommittee, which is investigating the federal government’s response to the coronavirus outbreak.

Because public health policy around the coronavirus pandemic has become so politically polarized, it’s unclear how well a confidence-building campaign from the government would play.

HHS officials acknowledge a major challenge to any campaign would involve finding trusted intermediaries to make the pitch to average Americans. On health care matters, people usually trust doctors first, not necessarily celebrities. And Trump has alienated much of the medical establishment with his dismissive comments about basic public health measures, such as wearing masks.

The 34-page “PSA Celebrity Tracker” compiled by Atlas Research and released by the committee does not say whether the celebrities were aware they were even being considered or if they had agreed to participate. The report says that no celebrities are now affiliated with the project but a handful did initially agree to participate.

Singer Marc Antony, who has been critical of Trump, pulled out after seeking an amendment to his contract to “ensure that his content would not be used for advertisements to re-elect President Trump.”

Actor Dennis Quaid also initially agreed and then pulled out, according to a document from Atlas Research. In an Instagram video post last month titled “No good deed goes unpoliticized,” Quaid said he was frustrated that a taped interview he did with Dr. Anthony Fauci, the nation’s top infectious-disease expert, for the campaign was portrayed in the media as an endorsement of Trump.

“Nothing could be further from the truth,” Quaid said, noting that the interview was still available on his podcast.

Antony and Quaid were among just a few celebrities who were approved for the campaign, according to the documents. Others included TV health commentator Dr. Oz and singer Billy Ray Cyrus.

“Spokespeople for public service campaigns should be chosen on their ability to reach the target audience, not their political affiliation,” the letter from the Democrats reads. “Yet, documents produced by the contractors indicate that the Trump Administration vetted spokespeople based on their political positions and whether they support President Trump.”

___

Associated Press writer Ricardo Alonso-Zaldivar contributed to this report.

Mary Clare Jalonick, The Associated Press

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How Virus Politics Divided a Conservative Town in Wisconsin’s North – The New York Times

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MINOCQUA, Wis. — When coronavirus cases began to spike in Wisconsin this fall, Rob Swearingen kept his restaurant open and let customers and employees decide whether they wanted to wear masks.

Mr. Swearingen, a Republican seeking his fifth term in the Wisconsin State Assembly, didn’t require other employees at his restaurant in Rhinelander to be tested after a waitress and a bartender contracted the virus because, he said, nobody from the local health department suggested it was necessary.

Kirk Bangstad, Mr. Swearingen’s Democratic opponent, took the opposite approach at the brewpub he owns in Minocqua, 30 miles away. He has served customers only outdoors, and when a teenage waiter became infected after attending a party, Mr. Bangstad shut down for a long weekend and required all employees to get tested.

Mr. Bangstad has since turned his entire campaign into a referendum on how Republicans have handled the coronavirus. On Facebook, he has served as a town shamer, posting lists of restaurants and stores in Wisconsin’s Northwoods that have disregarded state limits on seating capacity and don’t require masks.

With just days until the election, the contest for Mr. Swearingen’s Assembly seat in this lightly populated area in the Northwoods of Wisconsin serves as a microcosm for the way coronavirus politics are playing out across America. Mr. Bangstad is unlikely to prevail in a Republican-heavy district that covers parts of four counties stretching south from Michigan’s Upper Peninsula, but his effort to make the campaign a referendum on the virus echoes that of former Vice President Joseph R. Biden Jr., who has sought to make President Trump’s handling of the pandemic the central issue in the presidential contest.

Mr. Bangstad, a 43-year-old Harvard-educated former professional opera singer, moved back to Wisconsin six years ago from Manhattan, where he was a technology consultant and served as the policy director for Anthony Weiner’s 2013 mayoral campaign. Like Mr. Biden, he has eschewed traditional campaigning. He has moved his entire effort online, including in email and on the Facebook page of his brewpub, the Minocqua Brewing Company.

But unlike the former vice president, Mr. Bangstad has made little effort to win over voters who aren’t already appalled by Republicans’ handling of the coronavirus. Many of them, he said, are being duped by false or misleading statements by the president and the conservative news media.

“A lot of them, I feel, haven’t been equipped with the tools of media literacy or critical thinking skills to be able to discern if they’re being told something that doesn’t quite jell or is not true,” he said during an interview this week at his shuttered restaurant overlooking Lake Minocqua.

Rob Swearingen, a Republican State Assembly member, does not require staff or customers to wear masks at his restaurant in Rhinelander.
Credit…Chang W. Lee/The New York Times

Wisconsin’s 2020 campaigns are concluding while the state is in the midst of one of the nation’s worst coronavirus outbreaks. On Tuesday, as the state set records for the most new cases and deaths, Gov. Tony Evers said Wisconsin faces an “urgent crisis” and urged citizens to stay home.

Oneida County, which includes Minocqua and Rhinelander, where Mr. Swearingen operates the Al-Gen Dinner Club and has lived his entire life, has a virus rate nearly twice the state average over the past two weeks.

Scott Haskins, whose wife, Pamela, is a waitress at the Al-Gen, is among the county’s recent fatalities. Ms. Haskins contracted the virus after working a restaurant shift in mid-September and was hospitalized in early October. Mr. Haskins, 63, checked into the hospital with the virus four days after his wife, according to his daughter, Kelly Schulz.

Two days later, Mr. Haskins suffered a stroke and died.

“The day after my dad passed, Governor Evers put in the 25 percent capacity limit, and they weren’t abiding by it,” Ms. Schulz said of the Al-Gen. “People were posting pictures of themselves there on Facebook and it was pretty busy for a Friday night.”

Republicans who control the state legislature this month successfully sued Mr. Evers to overturn the capacity limits on bars and restaurants he ordered. In Oneida County, local sheriffs and town police departments weren’t enforcing them anyway.

Before winning election to the Assembly, Mr. Swearingen, 57, was the president of the Tavern League of Wisconsin, the powerful lobbying group for the state’s bars. He fought the state’s efforts to ban smoking indoors at businesses, lift the drinking age to 21 from 18 and increase the legal blood alcohol limit to drive.

Credit…Chang W. Lee/The New York Times

He said his restaurant is not responsible for employees who caught the coronavirus. No one from the local health department ever called with questions, he said, and no contact tracers contacted the restaurant. Mr. Swearingen said he has not had a test himself.

“There’s been no connection to the restaurant to all these cases,” he said during an interview in the dining room of the Al-Gen, which is bedecked with taxidermied heads of deer and black bears. “These people are part-time, coming from different jobs and different things.”

Of all the places where Democrats barely bothered to compete in 2016, Wisconsin’s Northwoods may have been the most neglected. Not only did Hillary Clinton skip Wisconsin altogether, county Democrats in this region didn’t even have yard signs to distribute, not that there was much demand for them.

Mrs. Clinton was a “polarizing’’ candidate, said Matt Michalsen, a high school social studies teacher who ran against Mr. Swearingen in 2016. “Personally, did I support her? No.”

Four years later, Mr. Bangstad has few expectations that he will win. He sees his campaign largely as an effort to increase Democratic turnout for Mr. Biden and cut into Mr. Trump’s margins by focusing attention on the impact of the coronavirus on northern Wisconsin.

Mr. Bangstad wrapped the side of his restaurant in a giant Biden-Harris sign that attracted the ire of the Oneida County Board, which sent a letter informing him that it exceeded the allowable size of 32 square feet. After Mr. Bangstad used the fracas to raise money and get more attention for himself in the local press, the board backed down.

At the same time, the Biden campaign and local Democrats have put far more resources into northern Wisconsin than they did four years ago. There are twice as many organizers focused on the area than in 2016. And though the Clinton campaign swore off yard signs as an unnecessary annoyance, the state party has made efforts to get them in every yard that would take one.

Credit…Chang W. Lee/The New York Times

“We distributed approximately 50 Hillary yard signs four years ago, and we’re at more than 1,200 so far for Joe,” said Jane Nicholson, the party chairwoman in Vilas County, just north of Oneida County.

There’s some evidence that Mr. Biden is making up ground. A poll taken for Mr. Bangstad’s campaign this month found Mr. Trump leading Mr. Biden in the district by five percentage points — a far cry from his 25-point margin of victory in 2016. The same survey found Mr. Swearingen ahead by 12 points, less than half his 26-point margin over Mr. Michalsen four years ago.

Mr. Trump won Wisconsin in 2016 by less than 23,000 votes statewide. His gap in Mr. Swearingen’s district alone was 14,000 votes.

“If we’re in the low 40s there, that means that we have blocked Trump’s path to pulling in the votes that he’d need to cancel out other areas of the state,” said Ben Wikler, the chairman of the Democratic Party of Wisconsin.

The Assembly race has engendered hurt feelings and worsened political divisions in Minocqua, a town of about 4,000 full-time residents. Down the street from the Minocqua Brewing Company, Tracy Lin Grigus, a Trump supporter who owns the Shade Tree bookstore, shook her head at Mr. Bangstad’s attempts to shame local businesses.

“On his Facebook, he’s calling all of us up here idiots, like a mini Joe Biden,’’ said Ms. Grigus, who doesn’t wear a mask in her store and doesn’t ask her customers to do so. “It’s insulting to people that share the space with him and other business owners. He’s like the only one in this town and surrounding towns that went this far.”

Across Oneida Street, the main drag through Minocqua’s small downtown, Casie Oldenhoff, an assistant manager at the Monkey Business T-shirt shop, where signs instruct customers to wear a mask, said Mr. Trump was to blame for the current wave of the pandemic.

Credit…Chang W. Lee/The New York Times

“He’s just not taking care of us,” Ms. Oldenhoff said. “He doesn’t care about what’s going on with the pandemic.”

Mr. Swearingen said he had little doubt that Mr. Trump would do just as well in the Northwoods on Tuesday as he did in 2016. Enthusiasm for the president is higher, he said, as evidenced by the regular boat and car parades adorned with Trump flags and carrying young men concerned foremost about a Biden administration taking away their guns.

But he said he had never been involved in a campaign as ugly as his own this year.

“We’ve been targeted by my opponent as a den of Covid and all sorts of rumors in Facebook,’’ he said. “I’ve never quite had to fight against Facebook in an election. He went after a couple of other bars in the area, and one of the bar owners was livid that that bar was on the list. It’s like, ‘Well, who are these people? It’s the mask police or something.’”

For Mr. Bangstad, shaming Mr. Swearingen and other Republicans who have fought against public health guidelines is exactly the point.

“If you’re a citizen in this state, and there’s one branch of government that’s trying to keep people healthy from Covid, and you have the legislative branch and the judicial branch trying to stymie him every single time he does it, it’s the saddest thing you’ve ever seen,” he said. “As a Wisconsinite, I’m just completely ashamed.”

Andy Mills and Luke Vander Ploeg contributed reporting.

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